More TOP patients required a narcotic prescription (60.9% vs 35.9% vs 33.3%, respectively; P = .010) compared to patients undergoing initial stent or URS. However, when an opioid prescription was provided, the total morphine milligram equivalents prescribed among each group was not statistically significant.

Patients electing initial treatment with TOP for renal colic due to stone disease were more likely to require narcotic prescriptions than patients electing initial surgical intervention.
Patients electing initial treatment with TOP for renal colic due to stone disease were more likely to require narcotic prescriptions than patients electing initial surgical intervention.
To capture the perspective of prospective urology applicants experiencing unique challenges in the context of COVID-19.

A voluntary, anonymous survey was distributed online, assessing the impact of COVID-19 on a large sample of US medical students planning to apply to urology residencies. Themes of (1) specialty discernment, (2) alterations to medical education, and (3) the residency application process were explored.

A total of 238 medical students, 87% third and fourth years, responded to the survey. While 85% indicated that the pandemic had not deterred their specialty choice, they noted substantial impacts on education, including 82% reporting decreased exposure to urology. Nearly half of students reported changes to required rotations and 35% reported changes to urology-specific rotations at their home institutions. Students shared concerns about suspending in-person experiences, including the impact on letters of recommendation (68% "very concerned) and program choice (73% "very concerned"). Looking to the possibility of virtual interactions, students identified the importance of small group and one-on-one communication with residents (83% "very important") and opportunities to learn about hospital facilities (72% "very important").

Despite the impacts of COVID-19 on medical education, prospective urology applicants appear to remain confident in their specialty choice. Students' biggest concerns involve disruption of away rotations, including impacts on obtaining letters of recommendation and choosing a residency program.
Despite the impacts of COVID-19 on medical education, prospective urology applicants appear to remain confident in their specialty choice. https://www.selleckchem.com/products/oxidopamine-hydrobromide.html Students' biggest concerns involve disruption of away rotations, including impacts on obtaining letters of recommendation and choosing a residency program.Cisplatin used as chemotherapy for various cancers may leads to accumulation of platinum within the kidney and disturb its function. Zinc oxide nanoparticles (ZnO-NPs) are of low toxicity nanomaterials and have many medical fields so this study aims to indicate ZnO-NPs effect in kidney injury induced by cisplatin. Adult male rats were pre-injected with one dose of ZnO-NPs (5 mg/kg IP) and after 2 h from injection, the rats were injected with also only one dose of cisplatin (6 mg/kg IP) and two additional groups were served as controls treated with either ZnO-NPs or cisplatin only, respectively, and normal control was involved and euthanization occurred after 7 and 12 days. Cisplatin-induced nephropathy increased kidney function parameters; serum creatinine, blood urea nitrogen and microalbuminuria. Conversely, these parameters were down regulated after ZnO-NPs treatment. ZnO-NPs reversed the decrease of renal superoxide dismutase, catalase and glutathione reductase and the increase of renal malondialdehyde induced by cisplatin. In addition, the annexin V demonstrated that the proportion of viable cells was significantly elevated and the proportion of apoptotic and necrotic cells significantly reduced. Also, the level of renal transforming growth factor beta 1 decreased in group pre-treated with ZnO-NPs. The Nuclear factor-E2-related factor, heme oxygenase-1 and endothelial nitric oxide synthase expression genes were up regulated while Bcl-2-associated X protein expression was down regulated in kidney tissue via ZnO-NPs. Histopathological and immunohistochemical observations were context with these findings. In conclusion, ZnO-NPs treatment revealed renoprotective effect against cisplatin drug, probably via its antioxidant, anti-inflammatory and antiapoptotic properties.
The ACR has established that diversity and inclusion are central to its mission of excellence in the radiologic professions; therefore, radiologists have a responsibility to serve the imaging needs of the transgender community. To understand radiologists' current knowledge of transgender topics, the authors performed a systematic review of publications from radiology journals.

A lexicon of 14 transgender-related terms was created and expanded through a PubMed keyword search. From the 129 journals from the radiology, nuclear medicine, and medical imaging category of Journal Citation Reports, 106 journals met the inclusion criteria, including English translation and Scopus data for the study period. Using the Scopus advanced search feature, articles with titles, abstracts, Medical Subject Headings terms, or key words including 1 of 14 transgender terms were identified and analyzed.

Of the more than 200,000 articles published by the 106 journals from January 2008 to July 2019, 29 relevant articles were identified. Only 14 of the 106 journals published any transgender-related topics. The volume of articles has increased over time. The largest proportion of articles was published under the "general radiology" subsection, with the majority of these being editorials (6 of 10). Most of the original research was published under "neuroradiology" (7 of 13). Use of nonpreferred language, such as "transsexual" and "natal sex" was present through2019.

Publication on transgender-related topics was uncommon among radiology journals. It is important to encourage further research and publication on transgender topics, as well as use of respectful, accepted language in radiology journals.
Publication on transgender-related topics was uncommon among radiology journals. It is important to encourage further research and publication on transgender topics, as well as use of respectful, accepted language in radiology journals.

Dangerous practices and games at school. Three separate categories of dangerous games can be distinguished. The non-oxygenating or fainting games, which consist of mechanical compressions or strangulative mechanisms. These are performed in the search of pseudo-hallucinogenic sensations. There are several such games from the simple but non-the-less dangerous "tomato game", performed by younger children (from 3-4 years of age), to the "choking game", between 7 and 14 years of age. "Aggressive" or "violent" games which use physical and psychological violence from a group of people towards a single individual. Acute neurological complications can be the consequence of such games, and their degree depends on the duration and intensity of the strangulation. These can vary from cerebral edema, loss of consciousness, long term cerebral damage (deafness, blindness, bedridden), irreversible coma and death. Physical consequences of aggressive games are equally important, such as vertebral fractures, cranial trauma, organ rupture. Victims of violence present repeated psycho-traumatic manifestations. Preventive messages associate information on the risks of such games with civic education (listening, solidarity and trust in others), the development of psychological and social skills, an active involvement in school-life and concrete responsibility taking. Early identification of symptoms of these practices by family members and professionals helps to avoid their repetition and increased danger, even addictive patterns.How to talk about a serious event to a child? Talking to a child about a serious event is difficult. Should we be afraid of causing him trauma? We will present two clinical situations each involving a pedophile father. The contrasting evolutions make it possible to highlight the important elements to be taken into account in this type of situation, by insisting on the variables relating to the child rather than the pressure that can be put by the entourage and the urgency of the event. Then, we will discuss the case of the death of a loved one and an other on the announcement to a child of a collective disaster the spread of the Covid-19.The child's conflictual family environment. Children and adolescents currently experience multiple family situations that feed their psychological construction towards adulthood. Conflicts between parents or the separation of the parental couple mark a change in the family system. Different psychological mechanisms can describe this impact, including the feeling of vigilance, the perception of a potential danger, or the belief that the person is at fault and responsible for the disputes. They can be articulated around cognitive skills (how the child assesses and understands the conflict), emotional possibilities (through his or her ability to regulate emotions in the face of conflict) and behavioural skills (how the child or adolescent is involved in the conflict). To create this environment, the use of family mediation centres makes it possible to create new opportunities for communication between parents. Child protection actors must be notified when acts of violence are committed against the child or adolescent, or if they are exposed to violent marital conflicts. Mental health systems offer specific care when characterized disorders have been identified. The commitment of both parents is sought to provide a space for everyone to express themselves.Environmental endocrine disruptors, what risks for children? Not all chemicals around us are endocrine disruptors. The effects of endocrine disruptors go through mechanisms that are probably more complex than those of conventional toxicity. A number of convergent data seem to confirm for some of them the possibility of deleterious effects on the male and female reproductive organs, as well as on the thyroid function. Sensitivity to these products is maximum during embryonic life, involving great caution regarding their use in pregnant women, young children and pubertal period. Many uncertainties persist regarding the consequences of their use. An enlightened discernment is therefore necessary when there is a possible toxicity, which will require a lot of studies.Does sport practice have an impact on the immune status ? Both sports and physical activity alter our immune system. Intense/prolonged acute exercise triggers an immunosuppression period which lasts longer in unfit individuals. https://www.selleckchem.com/products/nx-1607.html Although regular and well-designed workloads show immunostimulant and protective effects towards infectious diseases, highly-trained and elite athletes are definitively more vulnerable to microbial aggressions.Pediatric epilepsies. Epilepsies are a heterogeneous group of diseases characterized by the recurrence of epileptic seizures. The incidence is higher in children than in adults. Epilepsies are much more than the simple recurrence of seizures. Co-morbidities are common as well as daily-life activity restrictions. In children, special attention must be paid to schooling and behavioral difficulties in order to set up early intervention. Epilepsies with focal- onset seizures are the most common in children. Few syndromes account for the majority of pediatric epilepsies epilepsy with centro-temporal spikes, childhood absence epilepsy, juvenile myoclonic epilepsy and juvenile absence epilepsy. An appropriate syndromic diagnosis allows to conduct appropriate investigations, propose adequate treatment and explain the prognosis.Gaucher disease. Gaucher disease is a rare lysosomal autosomal recessive disease, caused by a deficiency of glucocerebrosidase, a lysosomal enzyme. The most frequent symptoms are cytopenia, splenomegaly, hepatomegaly, and potentially severe bone involvement (bone infarcts, avascular osteonecrosis, and pathological fractures). Neurological involvement may occur in type 2 and type 3 Gaucher disease. Patients with type 1 Gaucher disease have an increased risk of Parkinson disease, some solid cancers, and some hematologic malignancies including multiple myeloma. Patients often experience delays before their disease is being diagnosed. Thus, there is a need for physicians to recognize Gaucher disease symptoms to reduce the risk of irreversible complications.

04]. Compared with our previously published historical infection rate of 13% for these injuries, vancomycin powder was also associated with significantly decreased deep surgical-site infection (0% vs. 13%, P = 0.02). These results agreed with the matched analyses, which also showed lower infection in the vancomycin powder group (0% vs. 11%-16%, P ≤ 0.05).

Vancomycin powder may play a role in lowering surgical-site infection rates after fracture fixation. A larger randomized controlled trial is needed to validate our findings.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.Ipsilateral femoral shaft and tibial plateau fractures, termed a "floating knee" are rare and challenging injuries. There is limited literature guiding the operative technique and the outcomes associated with these injuries. https://www.selleckchem.com/products/nuciferine.html The author's preferred technique is early intramedullary of the femoral shaft fracture with knee spanning external fixation of any length unstable plateau fractures in the same operative setting. Early fixation of the femur fracture allows for improved hemodynamic and inflammatory stability. External fixation of the tibial plateau restores length and alignment and allows for soft tissue rest until definitive fixation. The purpose of this study is to describe this operative technique and determine the infection rate and complications requiring return to the operating room in patients with femoral shaft fractures and length unstable plateau fractures.Students at a Christian nursing school faced unanticipated challenges in preparing and presenting research projects during the COVID-19 pandemic. Students and faculty rapidly adapted to a virtual environment and overcame obstacles to complete and present their work. The students demonstrated resilience and additional learning outcomes as a result of the enforced virtual experience.Nurses have put themselves in precarious situations by caring for COVID-19 patients. Through the grid of faith, hope, and love as depicted in 1 Corinthians, the author commends the selfless work of nurses and esteems God's faithfulness to nurses who acknowledge him.Global pandemics and societal unrest add greater weight to nurses' workloads and personal coping abilities. Appropriate self-care includes assessing one's physical, emotional, and spiritual pulse. Taking needed breaks for rest and inner nourishment is essential.Nurses often juggle multiple roles and responsibilities that can result in an overfull life. An overwhelmed schedule can lead to unintentionally becoming distanced from Jesus. The author suggests that true self-care includes proper balance of one's spiritual life with God. Three interventions can rebalance an overwhelmed life seeking regular quiet time with God, prayer discernment about schedule decisions, and recognizing contemplative moments each day.This concept analysis of spiritual well-being (SWB) in the older adult seeks to improve nurses' integration of spiritual care. Using Walker and Avant's method, the author identified five defining attributes of SWB personal faith, religious practices, spiritual contentment, productive engagement, and healthy interpersonal relationships. Antecedents to SWB include awareness of one's spiritual needs and seeking to live a meaningful and purposeful life. Model, borderline, and contrary cases are presented to illustrate the defining attributes of SWB. Nursing implications for practice are discussed.As the incidence of diabetes rises in the United States, education on diabetes prevention and management is paramount. Diabetes programs offered in churches or community settings have reported positive outcomes such as weight loss and improved glucose control. Delphi Survey technique was used to identify spiritual interventions used by faith-based and community-based coaches in leading Diabetes Prevention Program (DPP) courses. Results showed that faith-based coaches reported using prayer, active listening, and emotional support in their DPP course; giving hope, incorporating humor, and using spiritual/sacramental activities were rated as important or very important by most coaches and can be used by faith community nurses in their practice.National and global disasters require immense resources, including nurses. Personal, professional, and spiritual preparation is strongly recommended for healthcare workers who desire to serve in disaster settings. Most nurses are underprepared for this role; options for preparation are described along with the ministry of nursing and spiritual care that expresses God's heart of mercy and care for hurting and desperate people.Two nurses, a mother and daughter, each participated in disaster relief efforts after Hurricane Andrew in 1992 and Hurricane Dorian in 2019. In recounting their experiences, both nurses demonstrate the vital contributions nurses can make at the sites of disasters. The invaluable role of churches in contributing to the disaster recovery effort is also described.Stigma is consistently recognized as a major barrier in the recovery from mental illness (MI). In addition to stigma among the general population, the MI-related stigma among healthcare providers often creates critical obstacles to access and quality care. Nursing educators who used the photovoice participatory learning activity to teach students how to identify labeling and stigma observed an increase in mental health awareness.In spite of an increased risk of transmission of influenza on college campuses, only 20% or fewer of college students in the United States receive the flu vaccine. This project evaluated an existing university program for flu vaccination, resulting in a collaboration pilot program in which a pharmacy conducted a mobile health clinic on campus. The percentage of students who obtained a flu vaccine from this initiative rose from about 4% to 9.46%, a 131% increase over the historical average.A review of 23 research articles to examine fertility awareness-based methods revealed biologic indicators and tracking methods to identify the fertile window in reproductive-aged women. This literature review indicated that a woman's cycle regularity is a major determinant of which method is best. Additionally, the woman's desire to achieve a pregnancy and her preference regarding the intensity of training are factors in method choice. Some evidence suggests that use of at least two biologic indicators is most effective for determining the fertility window. Recommended web and mobile applications also are discussed.

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